MEDICARE: DR. AMY H MOSLANDER-THOMPSON DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DE00010000	WA

General Provider Information

NPI Number	:	1649345844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY H MOSLANDER-THOMPSON DDS

Provider Business Mailing Address
First Line	:	9633 MARKET PL
Second Line	:	SUITE 202
City	:	LAKE STEVENS
State	:	WA
Zip	:	98258-7944
Country	:	US
Telephone Number	:	425-397-8888
Fax Number	:

Provider Business Practice Location Address
First Line	:	9633 MARKET PL
Second Line	:	SUITE 202
City	:	LAKE STEVENS
State	:	WA
Zip	:	98258-7944
Country	:	US
Telephone Number	:	425-397-8888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	02/02/2011

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